News

Hospital staff clean up beach in Kona on Hawai‘i Island

February 4, 2023 · 12:00 PM

https://bigislandnow.com/2023/02/04/hospital-staff-clean-up-beach-in-kona-on-hawaii-island/

 

 

 

 

 

 

 

 

 

 

Kona Community Hospital Employee Engagement Committee members conducted a beach cleanup at Old Airport last weekend, on Saturday, Jan. 28.

The committee, hospital employees, and family members spent several hours picking up rubbish on the shores of the beach park and in the picnic areas. Over a hundred pounds of trash were collected.

“We wanted to give back to our community outside of our facility as a healthcare community,” said Michelle Gray, current chairman of the employee engagement committee.

CEO Clayton McGhan said, “Kona Community Hospital staff are amazing … It was great to see the staff and their families come out for a singular purpose, to preserve the life and beauty of our beaches.”

 

Bill to select site for new Kona hospital awaits final committee hearing

 

‘How long will it take?’: Effort to secure new hospital for Kona renewed

By Laura Ruminski West Hawaii Today lruminski@westhawaiitoday.com | Monday, February 7, 2022, 12:05 a.m.

https://www.westhawaiitoday.com/2022/02/07/hawaii-news/the-first-step-in-a-very-long-journey-effort-to-secure-new-hospital-for-kona-renewed/

A bill in the state House to provide funding for a site assessment to find a viable location for a new hospital site in North Kona passed its first committee hearing Thursday.

House Bill 1638, introduced by Rep. Nicole Lowen (D-North Kona) seeks $1 million to identify and evaluate viable locations for a new hospital, a recurring endeavor brought up yearly in the Legislature.

Lowen said the site assessment is needed to lay the groundwork for building a new hospital in North Kona.

“We have to put one foot in front of the other,” she said. “If we don’t start talking about this now, how long will it take?”

 

Discussion about the need for a new hospital to serve residences in North and South Kona has been ongoing for nearly two decades. The area is currently served by the 94-bed Kona Community Hospital in Kealakekua, a Hawaii Health Systems Corp. facility constructed in 1974.

“The population in the Kona area has grown and migrated north since the hospital was built almost fifty years ago, so the hospital is no longer located in the area with the highest residential density and need for services. While the highway in North Kona has been expanded, the hospital in South Kona sits on a single-lane highway that is vulnerable to traffic congestion, making it difficult for emergency vehicles and others to reach the hospital quickly,” the proposed bill reads.

The bill further states a new, more modern facility can provide additional services, better access to Kona International Airport, which is nearly 20 miles from the current facility, for medical airlifts, and a more convenient location for the area’s residents. The new hospital would also serve as an attractive workplace and help the state recruit doctors and health care workers to fill the state’s critical need.

According to a November 2021 report submitted to the 2022 state Legislature, there are currently 10,592 physicians licensed to practice in Hawaii, but just 3,290 are actively providing patient care and provide 2,857 full-time equivalents of direct patient care. The number of full-time equivalents was up 45 over 2020.

The number of doctors, however, does not meet the state’s demand, according to the Hawaii Physician Workforce Assessment Project. Hawaii, according to a demand model based on U.S. average physician use, needs 3,395 full-time equivalents of practicing physicians.

“This indicates a shortage of 537 FTE of physician services. However, when island geography and unmet specialty specific needs by county are examined, the estimated unmet need for physicians (accounting for geographic distance and air travel) increases to 732 FTEs,” the report reads. “The demand model predicts our demand will increase by 38 FTE a year. If we only increase our workforce by 50 a year, we will not meet our demand in the foreseeable future.”

According to the report, Hawaii County needed to increase its number of physicians by 40% or 187 doctors to meet demand in 2021. An additional 16 primary care providers were needed to meet demand in that field alone.

All of the written testimony submitted to the House Committee on Health, Human Services and Homeless supported the measure.

Hawaii County Mayor Mitch Roth in his testimony wrote: “Enhancing the health and well being of our entire community is a priority for my administration and facilitating access to quality medical sen/ices is central to that commitment. Presently, the only available acute care in the area is provided through an aging hospital located 20-30 minutes away from where the population growth has been in Kona over the past three decades.”

Jim Lee, who is the Regional CEO for the HHSC and oversees Kona Community Hospital, noted West Hawaii’s population is currently growing faster than both North and East Hawaii. In 2018, prior to the pandemic and influx of residents amid remote work and other opportunities, population growth in West Hawaii was projected to increase by 6.1% by 2023. Reflecting this growth, inpatient and emergency department visits among West Hawaii residents have been increasing.

Last year, Kona Community Hospital recorded 22,000 emergency room visits.

Though able to meet the community’s needs, the hospital’s aging infrastructure has major deficiencies, with many critical systems in urgent need of repair and renovation.

Judy Donovan, regional marketing and strategic planning director, said the West Hawaii Region Board recently approved a six-year, phased in master facility plan to address the repairs and expansion needed, estimated to cost $80 million.

“The infrastructure is crumbling. It needs a new roof and a new wastewater treatment system, among other improvements,” said outgoing Board Chairperson Dr. Frank Sayre.

With an estimated price tag of $300 million for a new facility, Sayre said the money for repairs to the current hospital are critical given the length of time it will take to secure funding and finalize construction of a new one.

Donovan said the top three priorities include $22.5 million for the design, construction and equipment for a new oncology building, $2.5 million to repair the roof, and $3.5 million for the renovation of the Emergency Department.

“In addition, we need $20 million for a new electronic medical records (EMR) system, which is not in the master facilities plan,” said Donovan.

The existing EMR system expires in June 2023.

Sen. Dru Kanuha (D-Kona, Ka‘u) has included funding requests for the hospital in his request via Senate Bill 3383. In addition to the three projects Donovan listed, Kanuha is asking for $2 million to upgrade wastewater treatment and money to replace the EMR with an EPIC system.

“We struggle almost daily with the very real potential that one system failure or another could shut down hospital operations,” said Lee.

“It’s more than time that something happens. It’s the first step in a very long journey,” said Sayre

KCH Looks to Grow Staff Through Specialty Hires, New Accredited Program

By Tiffany DeMasters
November 9, 2021, 2:00 PM HST

Hospital is looking at long-term solutions to expand and bolster its workforce.

As the last of the federally-funded health care workers leave the island this week, KCH has begun efforts in building out staff, from starting recently graduated nurses in specialty units to offering a nine-month surgical tech program.

Stephanie Irwin, KCH Director of Education, said the hospital is looking at hiring in more specialty areas, including the emergency room. For the first time in KCH’s recent history, the hospital hired a newly graduated nursing student from Hawaiʻi Community College at Palamanui in 2020 into the behavioral health unit, which is considered a specialty.

“There’s a nursing shortage and being able to start someone in a specialty area is exciting,” Irwin told Big Island Now.

KCH hires about three nurses a year from the nursing program at Palamnui. Officials say these new hires typically work six months in the Med Surge Acute unit before moving into a specialty.

The last graduating class at Palamanui in May brought in three nurses as RPN II’s. Aside from the specialty unit hire, the remaining two were assigned to Med Surge Acute units.

“The newly graduated nurses are assigned to a senior nurse who will orient them for six months,” said KCH spokesperson Judy Donovan. “Once their six-month orientation is completed, they will be RPN IIIs.”

Kathleen Kotecki, retired associate professor of nursing from Palamanui, said while there is a need for nurses, there is a shortage in positions available for newly graduated nursing students. The idea of moving new nurses directly into specialty units may help with that as KCH is not limited to just those positions offered to new health care workers.

“Looking at the big picture, we’d have to expand the program so we could graduate more students,” Kotecki said. “Getting more admissions to the nursing program is key. We need new, younger nurses.”

Additionally, Donovan said the goal is to hire three graduated nurses every year with the hope to increase the number to five.

“We will continue this practice in an effort to grow workforce from (within) our local community,” Donovan said.

In an effort to grow from within, KCH will begin its newly accredited surgical tech program, which is set to start in August 2022 with three students, who are currently employed at KCH. Upon completion of the program, the health care workers will be certified to be integral members of the surgical team at KCH.

Irwin said this will be the only program of its kind on the Big Island. It will also be the first accredited program launched at KCH.

“This is a specialized employee position that is difficult to fill,” Donovan said. “Currently, we have a full-time surgical technologist who is also an instructor. We recognized the opportunity to develop a program that will fill an existing employee gap.”

Irwin, a Palamanui nursing graduate, has worked at KCH for 12 years. While it can be wonderful to hire nurses outside the state, Irwin said it can also be hit and miss as they come and end up not staying on the island.

“But when we hire within, itʻs amazing how long they stay,” Irwin said.

KCH currently has 10 full-time positions open, including in the ICU, ER, floats and imaging. Additionally, the in-house lab, Clinical Laboratories is struggling with staffing.

Donovan said the hospital started with 42 FEMA-funded clinicians during the spike of the coronavirus cases over the summer, including critical care nurses, respiratory therapists and imaging staff. Nine of those workers remain as a majority of the health care workers left two weeks ago.

With their contract officially ending on Thursday, Nov. 13, Donovan said four of the FEMA-funded workers have expressed interest in converting to a standard agency contract.

Hawai´i on Brink of Healthcare Crisis as Pandemic Booms

By Max Dible
August 12, 2021, 4:06 PM HST
* Updated August 14, 6:45 AM

https://bigislandnow.com/2021/08/12/hawaii-on-brink-of-healthcare-crisis-as-pandemic-booms/

 

UPDATE: A PREVIOUS VERSION OF THIS ARTICLE INCORRECTLY STATED THAT 35 EMERGENCY EMPLOYEES HEADED TO KONA COMMUNITY HOSPITAL WOULD BE PAID FOR BY FEMA. IN FACT, A PRIVATE DONOR IS PAYING FOR THE FIRST WAVE OF HEALTHCARE WORKERS. FEMA WILL PAY FOR EMERGENCY STAFF MOVING FORWARD.

The State and County of Hawai´i are on the edge of a healthcare crisis.

Visitor restrictions and hospital lockdowns are back in effect across the Big Island as healthcare facilities near patient capacities, a situation directly linked to the massive increase in coronavirus cases across the county. More than 5,000 infections have been reported on the Big Island since the pandemic began, with more than 1,300 currently active.

Exacerbating the situation are shortages of medical personnel.

“Critical staffing shortages continue to challenge all units at (Kona Community Hospital),” KCH Marketing and Strategic Planning Director Judy Donovan wrote in a press release Thursday, Aug. 12.

It is a problem Donovan said KCH will soon address.

“We are looking forward to welcoming 35 clinical staff, including critical care nurses and respiratory therapists, on Monday, Aug. 16,” she added.

The additions will be paid for by a donor who asked to keep their name and the amount donated private. Future emergency hires will be funded by the Federal Emergency Management Agency (FEMA).

But even if healthcare centers can staff enough personnel to keep up with case counts that have been on the rise statewide for weeks, facilities themselves can not be enhanced so quickly.

Hilo Medical Center (HMC) reported earlier this week that it is already nearing capacity, and just 24 patients are currently hospitalized for COVID-19 island-wide, not all of them at HMC. The number is almost certain to rise, as only 58% of the county is fully vaccinated and the Big Island’s seven-day average is 94 new infections every 24 hours. To make matters worse, most of those cases are connected to the now-dominant Delta variant, which is both highly transmissible and results in more severe symptoms than did earlier strains.

HMC has opened a COVID unit, which can accommodate 16 patients, not including those requiring care in the hospital’s intensive care unit (ICU). But the number of COVID patients is not the only problem.

More people have sought inpatient care for standard ailments, as more patients have become vaccinated and the pandemic has settled in as an element of everyday life. That has resulted in less aversion to seeking in-person medical treatment than was seen last year when the pandemic was still new, medical professionals say. This development has crowded hospitals further and stretched resources thinner, also putting at higher risk patients in need of critical care unrelated to COVID-19.

The situation would not be solved, but can be significantly alleviated, with higher vaccination rates. According to Department of Health statistics, 61.1% of all Hawai´i residents are fully vaccinated and 68.7% have received at least one dose.

Hilton Raethel, president and CEO of the Hawai´i Healthcare Association, told Hawaii News Now (HNN) that as of Thursday, there were 282 individuals hospitalized with COVID-19 statewide. Of that group, 91% are unvaccinated.

“This is really stressing out hospitals across the entire state. COVID patients take a lot of work,” Raethel told HNN’s “This Is Now” program. “Fortunately, not as many are in the ICUs (or) are on ventilators as they were last year, at least proportionately. But the sheer volume of cases and the fact that they are infectious creates a drain on our healthcare system.”

KCH said Thursday that it is currently caring for nine COVID patients, none of whom are vaccinated. Four are residing in the ICU.

“Since we began measuring vaccine status of admitted patients, only one COVID positive patient was vaccinated,” Donovan said. “We strongly encourage anyone who has been postponing receiving the COVID vaccine to do so now.”

No visitors are being allowed into KCH, save for a few “compassionate exceptions” in the cases of laboring obstetrics patients and those facing end-of-life circumstances, Donovan continued.

As of Thursday, Kohala Hospital has reinstated a lockdown of its facilities, meaning visitors will not be allowed.

Governor David Ige on Tuesday, Aug. 10 announced an executive order that immediately reinstated several coronavirus-related restrictions throughout Hawai´i.

The order reset social gathering limits in all settings to 10 individuals indoors and 25 outdoors. For high-risk settings, such as restaurants, bars, gyms and other social establishments, maximum capacity was reduced to 50%. All patrons of such settings are mandated to maintain six feet of social distancing, are not allowed to mingle between tables, and must wear face coverings at all times, even when seated, if not actively eating or drinking.

Furthermore, professional events planned to accommodate more than 50 individuals, such as weddings, conventions, concerts, etc., must submit virus-mitigation protocol to the relevant county agencies for a sign-off in order to host those events legally.

“We are seeing widespread community transmission,” Ige said. “We need to take action, and we need to take action now. We need to minimize person-to-person contact in order to reduce transmission.”

The governor added he believes mandates will need to be in place for four to six weeks before Hawai´i might track any statistically significant benefit from them.

HFS FCU members and staff raise $10,000 for foundations
Friday, August 13, 2021, 12:05 a.m.

https://www.westhawaiitoday.com/2021/08/13/features/hfs-fcu-members-and-staff-raise-10000-for-foundations/

Throughout the month of June, HFS Federal Credit Union staff and members helped to raise funds for two local foundations during their Annual Fundraiser: the Hilo Medical Center Foundation and the Kona Hospital Foundation.

The Hilo Medical Center Foundation has supported East Hawaii for over 25 years, while the Kona Hospital Foundation has provided care to the West Hawaii communities for over 35 years. Both have diligently supported the Big Island around the clock throughout the pandemic. Each organization will be receiving $5,000, consisting of donations from generous credit union members and staff.

“Hilo Medical Center Foundation and our Board of Trustees are so grateful to the staff and members of HFS Federal Credit Union for their generosity and support to keep access to high quality health care close to home,” said Lisa Rantz, executive director of the Hilo Medical Center Foundation.

New KCH Protocol Offers Closure for Families, Nurses After Death of Patient

By Tiffany DeMasters
June 14, 2021

https://bigislandnow.com/2021/06/14/new-kch-protocol-offers-closure-for-families-nurses-after-death-of-patient/

Jen Davis still remembers the emptiness she felt the night her fiancé Elvis Sheppard passed away four years ago.

Davis, 39, was walking down a hallway out of Kona Community Hospital’s emergency room toward the dozens of people waiting for an update on Sheppard’s condition following his motorcycle crash.

“I just collapsed in the hallway — I’m crying in the hallway,” Davis told Big Island Now. “Then someone picked me up, we exited and I drove home.”

The grief of her fiancé’s death was compounded by a lack of resources from the hospital aimed at helping people navigate the loss of a loved one.

“It was like here’s the door, exit stage right,” Davis said.

Recognizing a need to extend their dedication of care beyond the loss of life, a group of KCH staff formed the Circle of Life Committee (COL) and put a Code Lavender in place at the facility. Code Lavender helps humanize that empty moment, as well as honor those who have passed and give support to those facing the uncertainties of grief and loss.

“(As a nurse) you have the functions of what you’re supposed to be doing, while you’re trying to read the room and be human about it,” said KCH nurse Valerie Pedrami and member of COL. “Once the patient has passed, there’s a stillness, an emptiness in a way.”

Code Lavender was created out of Pedrami’s passion to turn that moment of emptiness into something meaningful. The catalyst, the nurse said, were a
couple of employees who lost loved ones.

“I felt we weren’t doing enough to show we cared,” Pedrami said.
“We wanted to do more, not just for patients but for cohorts.”

Sheppard’s death — and its impact on Davis — made the need for Code Lavender even more apparent.

“I remember promising (Davis) I would make a change,” Pedrami recalled.

CODE LAVENDER

As an experienced critical care nurse, Pedrami can anticipate a patient’s death and mentally prepare herself.

None of it’s easy, she said, for the families or attending nurses.

“It’s always sad,” Pedrami explained. “It’s very emotionally charged, especially if there’s family present. It’s palpable — the emotions, sadness, the anxiety.”

COL, created in 2020, made its mission to create meaningful, respectful experiences for patients and KCH ‘ohana through education and tools relating to traumatic events, end-of-life matters and bereavement. Part of those tools was the adaption of a “Code Lavender,” developed at Santa Barbara Cottage Hospital in California, and tailored to the needs and culture at KCH.

Code Lavender provides support and closure between death and postmortem for both          nurses and families. “As a nurse, you can be stoic, but the reality is you have to zip up a      body bag and go down to the morgue,” Pedrami said. “This (Code Lavender) bridges            the gap. It’s taken a lot of work, but it’s rewarding work.                                                        Code Lavender was activated at KCH for the first time in May. Various elements of the      new protocol include the creation of comfort carts that hold items like stress balls,                aromatherapy, coloring books and books on grief available for a patient’s family.

Images of purple butterflies are now posted outside the door of a dying patient’s room    ensuring people in the area act respectfully and with reverence. After a patient dies,              staff now offer a Lavender Ceremony where a nurse reads a poem memorializing the            deceased. The ceremony is voluntary.

Pedrami performed the Lavender Ceremony for the first time in May. She said she was        nervous to ask them, but her intuition spoke to her and had a feeling the family would        be receptive.

“It was rewarding for my spirit and the family to put into words that we care,” Pedrami said. “Having your moment to kind of say your peace gives you closure and humanizes the moment.”

While the hospital already had literature on grief and some resources, Pedrami said, they did an overhaul of the material, creating an end-of-life resource book. Pedrami said the booklet talks about changes families will see in their loved ones as they come near their deaths.

It’s also a resource as it provides numbers to the mortuary and information on how to get a death certificate. KCH also has a different booklet on grief and the grieving process. Materials were used from Hospice of Kona but tailored to KCH.

The committee also created debriefing champions, who are available for a debrief session three days after Code Lavender has been activated. Pedrami said the hospital does have counseling available to staff, but the debriefing champions allow for staff to address the emotional trauma at the moment.

EAS ABIDE INITIATIVE

Code Lavender, Davis said, gives value to the life that’s been lost.

The night Sheppard died, Davis remembers having to sit down with doctors who were trying to explain to her what was going on.

“As a layperson, he was speaking a foreign language,” Davis recalled. “My body was in shock, nothing was registering to me. We were getting married in 28 days. I didn’t understand he was dying.”

After Sheppard’s death, Davis spoke to Pedrami about the lack of support and services and what needed to happen to change it.

“Val (Pedrami) is amazing. All the (KCH) nurses there are all incredible,” Davis said. “There was a need for it and this need has been addressed. It’s so touching to me that they heard me and that someone will be helped through this.”

While Pedrami and KCH staff were working on an adaptation of Code lavender, Davis found ways to support their efforts as well as honor Sheppard.

Davis along with friend and registered nurse Anne Broderson, founded the Elvis Sheppard blood drive in hopes of educating the public about the need for blood donors. It’s been held annually since 2017. In 2019, they broke the state record’s for largest collection in a single-day drive.

During the 2019 blood drive, Broderson and Davis held drawings in an effort to raise funds for the Kona Hospital Foundation’s Trauma Services. The women hoped the money collected would go toward a bereavement program.

“It’s all part of the bigger picture,” Davis said, calling the bereavement program “the best way to honor who he (Sheppard) was to all of us.”

Davis and Broderson raised approximately $30,000 that went toward funding aspects of Code Lavender, including getting materials for the comfort cart.

Broderson and Davis’ vision for a bereavement program was clear. They wanted there to be more education for the staff and effective communication to create fewer problems in the future.

“We wanted something focusing on the staff too,” Broderson said. “It’s extremely hard on the staff to watch someone die. People expect staff to be used to it.”

Davis thinks KCH has done an incredible job creating a bereavement program.

“Everything we were talking about, they addressed it,” Davis said. “It’s good no one will have to do this ever again. People will have help.”

Broderson, who was also friends with Sheppard, was with Davis the night he died. While there was a lot of confusion that night, Davis said, Broderson was there at her side.

A KCH nurse at the time, Broderson was off duty when Sheppard was brought in. She did what she could to help Davis understand what was happening and translated the medical jargon.

“It’s hard to take that extra time to answer questions and address all the things that come up,” Broderson said. “I was in a unique situation; I could be that person to take the extra time to serve in that role.”

Pedrami and COL gave a presentation to Davis and Broderson on Code Lavender and the additional changes to education KCH now provide. Broderson recalls being surprised how powerful the Lavender Ceremony was at providing closure.

Moving forward, both Davis and Broderson are optimistic that Code Lavender will change the experience of losing a loved one from emptiness to feeling supported.

“I think it’s cool to see the loss of someone so loved to carry over and benefit people in the future,” Broderson said. “We know Elvis would be proud of what’s been created in his memory.”